Creatine monohydrate in resistant depression: a preliminary study.

Objectives: Creatine plays a pivotal role in brain energy homeostasis, and altered cerebral energy metabolism may be involved in the pathophysiology of depression. Oral creatine supplementation may modify brain high-energy phosphate metabolism in depressed subjects.

Methods: Eight unipolar and two bipolar patients with treatment-resistant depression were treated for four weeks with 3-5 g/day of creatine monohydrate in an open add-on design.

Posttraumatic stress disorder, tenderness, and fibromyalgia syndrome: are they different entities?

Objectives: Many features of fibromyalgia syndrome (FMS) resemble those of posttraumatic stress disorder (PTSD). The goal of this study was to investigate the comorbidity of FMS and PTSD in a cohort of men following an intensive, initial, defined traumatic event.

Methods: One hundred twenty-four males (55 patients with PTSD, 20 patients with major depression, and 49 controls) were evaluated for the presence of FMS.

Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non-PTSD subjects.

Motor vehicle accidents (MVAs) are the leading cause of posttraumatic stress disorder (PTSD) in the general population, often with enduring symptomatology. This study details epidemiological and clinical features that characterize PTSD among MVA victims living in a nonhospitalized community setting long after the MVA event, and includes exploration of premorbid and peritraumatic factors. MVA victims (n=60; 23 males, 37 females) identified from the registry of a community general health outpatient clinic during a 7-year period were administered an extensive structured battery of epidemiological, diagnostic and clinical ratings.

Is elective surgery traumatic for children and their parents?

Aim: The emotional consequences of elective surgery to children and to their parents have not been sufficiently studied. The aim of the present study was to prospectively assess the prevalence and severity of post-traumatic, anxiety and depressive symptoms in this population.

Methods: Forty children and adolescents consecutively admitted for elective surgery in a general hospital participated in the study.

An open-label randomized comparison of olanzapine versus risperidone in the treatment of childhood-onset schizophrenia.

Background And Purpose: Childhood-onset schizophrenia (COS) is a clinically severe form of schizophrenia, which causes severe impairment to cognitive, linguistic, and social development. There are few prospective and retrospective open clinical trials of risperidone and olanzapine in COS. In this open-label, randomized, prospective study, we compared the tolerability and effectiveness of risperidone versus olanzapine in the treatment of COS patients.

Assessing mental disability in minors.

Forensic psychiatry devotes a great deal of attention to the "imprecise" and "insufficiently scientific" nature of psychiatric disability assessment, and, for this reason, it is vitally important to establish a reliable method of assessing different levels of disability. The assessment of mental disability in minors is unique in that it involves developmental aspects, which affect the formation and outcome of the disability. The relationship between disability and development is reciprocal: disability can affect development, thereby intensifying the degree of disability, while development affects integration of the disability into the personality and self-image, thereby preventing or reducing the transformation of disability into handicap.

Therapy for the middle-aged: the relevance of existential issues.

Middle age is a normative developmental stage. Although further research is still required, there is general agreement in the literature as to the principal changes, conflicts, and tasks that are characteristic of this stage in life, and in particular, as to the nature of the transition to the second half of life, or what is commonly known as "midlife crisis." The dynamic psychotherapeutic approach to the middle-aged patient does not differ in essence from that adopted toward adolescents or the elderly.

Reboxetine versus fluvoxamine in the treatment of motor vehicle accident-related posttraumatic stress disorder: a double-blind, fixed-dosage, controlled trial.

Background: Motor vehicle accidents (MVAs) are a leading cause of posttraumatic stress disorder (PTSD) in the general population. Alterations in norepinephrine and serotonin systems have been proposed as mechanisms involved in the pathophysiology of the condition, with treatment directed at these neurotransmitter systems. Reboxetine, a selective norepinephrine reuptake inhibitor, exhibits high affinity and selectivity for the human norepinephrine transporter.

Remifentanil supplementation of propofol during electroconvulsive therapy: effect on seizure duration and cardiovascular stability.

Objectives: Electroconvulsive therapy (ECT) is standard treatment of severe depression. The induction of a seizure is a core event in successful ECT. Although propofol is a frequently used anesthetic agent, one of its limitations is a reduction of seizure duration.

[Prophecy and mental illness].

It is a well known platitude that a mentally ill person may "think that he is God" or "believes that he is the Messiah". Despite the generalization and shallowness of this attitude, sometimes psychotic patients indeed have delusions with contents of divine revelation, messianic assignments or prophetic power. In this current article we examine the different connections between prophecy and mental condition, especially psychotic.

Reboxetine as an optional treatment for hyperkinetic conduct disorder: a prospective open-label trial.

Background And Purpose: Hyperkinetic conduct disorder (HCD) has been identified as a common psychiatric diagnosis among children and adolescents. This disorder affects many life aspects of both child and family. The aim of this study was to examine the efficacy of the selective norepinephrine reuptake inhibitor (SNRI), reboxetine, in treating children with HCD and its influence on associated symptoms, such as aggressiveness, impulsivity, anxiety, and depression.

Comparing aspects of mental health legislation of Israel and Massachusetts.

This paper compares the manner in which two sets of mental health laws, that of Massachusetts, U.S.A.

Clozapine in the treatment of obsessive-compulsive symptoms in schizophrenia patients: a case series study.

Introduction: Obsessive-compulsive (OC) symptoms have been observed in a substantial proportion of schizophrenic patients. There are some reports describing the appearance de novo or reemergence of preexisting OC symptoms under clozapine (CLZ) therapy. However, there are also reports describing a positive effect of CLZ therapy in OC schizophrenic patients.

Olanzapine treatment in chronic drug-resistant childhood-onset schizophrenia: an open-label study.

The use of typical antipsychotics is limited in children with schizophrenia, owing to the high rate of response failure and early appearance of extrapyramidal syndromes as well as tardive and withdrawal dyskinesia. The aim of the present study was to examine the effectiveness of the atypical antipsychotic olanzapine in the treatment of childhood-onset schizophrenia. The study sample included nine children hospitalized for schizophrenia who had proven refractory to treatment with at least two antipsychotic drugs.

Variability of color choice in the Lüscher Color Test--sex differences.

In this preliminary investigation of variability of responses on the Lüscher Color Test, subjects were 567 volunteers administered the test twice with a 10-min. interval between them. Two hypotheses were tested: (a) that variability of responses attests to the personality of the respondent (tested by the relations of variability and MMPI scale scores), and (b) variability of responses is based on learning the test's content.

Risperidone, but not olanzapine, decreases bone mineral density in female premenopausal schizophrenia patients.

Background: The hyperprolactinemia induced by conventional antipsychotics often leads to osteoporosis. The commonly used atypical antipsychotics risperidone and olanzapine vary in their hyperprolactinemic properties. Therefore, we compared hormone profiles and bone properties in female premenopausal schizophrenia patients treated with either risperidone or olanzapine.

Plasma testosterone levels in patients with combat-related posttraumatic stress disorder.

Background: An abnormal level of androgens has been reported in various psychiatric disorders and the important role of androgens in the regulation of human sexuality, aggression, cognition, emotions and personality have been described. Previous studies in the area of stress and the hypothalamic-pituitary-gonadal (HPG) system in humans indicate that circulating testosterone levels are suppressed by physical and psychological stress. However, there is also evidence that plasma levels of testosterone can increase during potentially stressful events and may be elevated in combat-related posttraumatic stress disorder (CR-PTSD) in comparison with normal subjects and major depressive disorder patients.

Association between flupenthixol treatment and emergence of manic symptoms.

Background: Flupenthixol is an antipsychotic drug with known mood-elevating properties. Its propensity to induce manic symptoms has not been investigated.

Methods And Results: We describe six patients, four with schizophrenia and two with bipolar disorder, in whom flupenthixol treatment was associated with emergence of manic symptoms.

Informed consent: myth or reality.

The rapidly growing awareness and respect of the social needs and legal rights of the patient in many countries is a sign of cultural maturity of society at large. However, the implementation of these achievements is especially arduous in the field of psychiatry because often mental patients have cognitive restrictions and/or emotional distress both of which may interfere with the exercise of their civil rights. One focus of this paper is the challenging process of obtaining legally valid consent from a severely ill psychiatric patient for diagnostic procedures and for treatment and also for participation in research projects.

The influence of three months of methylphenidate treatment on platelet-poor plasma biogenic amine levels in boys with attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is related to dysregulation in the activity of brain monoamines. The aim of the present study was to assess the impact of three months' methylphenidate (MPH) treatment on platelet-poor plasma (PPP) norepinephrine (NE), dopa and serotonin (5-HT) levels as well as on ADHD symptomatology. Three months of MPH treatment in 16 ADHD boys, aged 11.

Elevated circulatory level of GABA(A)--antagonistic neurosteroids in patients with combat-related post-traumatic stress disorder.

Background: Post-traumatic stress disorder (PTSD) is a multisystem neurobiological disorder with chronic alterations in various neurochemical systems. Levels of the GABA(A)--antagonistic neurosteroids plasma dehydroepiandrosterone (DHEA) and its sulphate derivate, dehydroepiandrosterone sulphate (DHEAS) may be relevant to depressive and anxiety disorders, including PTSD.

Methods: We assessed the circulatory levels of morning plasma DHEA and DHEAS in 21 male outpatients with untreated chronic combat-related PTSD (CR-PTSD), and 18 healthy control male subjects.

Sildenafil citrate for the sexual dysfunction in antidepressant-treated male patients with posttraumatic stress disorder. A preliminary pilot open-label study.

Background: Previous studies have suggested that posttraumatic stress disorder (PTSD) may be associated with pervasive sexual dysfunction. Sildenafil citrate was established as a highly effective and well-tolerated oral agent for the treatment of sexual dysfunction of various etiologies. There are no studies that have examined the efficacy of oral sildenafil in PTSD patients with sexual dysfunction.

Zuclopenthixol treatment of behavioral disturbances in mentally retarded children and adolescents: an open-label study.

The present open-label study assessed the efficacy of zuclopenthixol, an thioxanthene neuroleptic with combined dopamine receptors (D1/D2) antagonist activity, in the treatment of severe behavioral disturbances in mentally retarded children and adolescents. A sample of 15 (11 males, 4 females) mentally retarded children and adolescents, ages 5-18 years (12.2 +/- 2.

Psychological distress around menopause.

The authors sought to identify a subgroup of women who are likely to experience psychological distress in the period around menopause. A sample of 189 women (mean age=49.49) was selected from the general population and rated for menopausal status, menopausal symptoms, depression, anxiety, perceived control, body image, and sex role.